Background: Pulmonary rehabilitation (PR) is recommended in the treatment of people with idiopathic pulmonary fibrosis (IPF). Little is known about the experience of people with IPF of PR or the impact of PR on physical activity (PA) in people with IPF. COVID-19 saw a shift towards the delivery of remote PR.

Aims: To explore the experience of virtual PR (VPR) in people with IPF and the impact on participants PA.

Methods: Consecutive patients with a diagnosis of IPF were invited to participate in virtual PR: a 10 week exercise programme delivered twice-weekly. One-to-one semi- structured interviews were conducted within one week following the conclusion of the programme. All interviews were recorded, transcribed and analysed using Braun and Clarke thematic analysis. Participants wore an Actigraph accelerometer around their waist for 7 days before and after PR.

Results: Sixteen participants were recruited. Mean (standard deviation (SD)) age 71(12) years; 9M:7F.  Mean (SD) FEV1 2.3(0.3)L, FVC 2.8(0.7)L.  Four key themes were identified: (1) The impact of VPR on health and outlook, (2) The reality of VPR, (3) Being active after VPR and (4) Living with IPF during the COVID-19 Pandemic. Improvements in PA were identified: Moderate-to-vigorous PA (MVPA): Baseline (BL) 19(18.6) minutes, Post-intervention (PI) 25.3(27.2), step count: BL 3838 (2987), PI 4473 (3622).

Conclusion: Despite the progressive nature of IPF, all participants expressed high levels of enjoyment with VPR. PR can improve PA in people with IPF, wide variations in changes were observed. A fully powered trial is required to fully explore the impact of PR on PA in people with IPF.